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Publisher: Elsevier   (Total: 3031 journals)

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Showing 1 - 200 of 3031 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 20, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 16, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 79, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 22, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 27, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 303, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription  
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 196, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 9, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 21, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 5, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 119, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 8, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 24, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 21, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 26, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 24, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 8, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 4)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 39, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 38, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 41, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 14)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 11)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 18, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 22)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 33, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 4)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 7, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 1)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 8)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 5, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 21)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 6, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 3)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 20, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 14)
Advances in Pharmacology     Full-text available via subscription   (Followers: 13, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 7, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 17, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 56)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 1, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 332, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 7)
Advances in Surgery     Full-text available via subscription   (Followers: 6, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 28, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 14)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 12)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 42, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 303, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 4, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 7, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 388, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 29, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 36, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 48, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 3, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 9, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 5)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 7, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 6, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 45, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 45, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 34, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 32, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 25, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 31, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 48, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 173, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 51, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 2)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 22, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 23, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 32, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 13, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 52, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 3)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 38, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 151, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 7, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 10)
Anesthésie & Réanimation     Full-text available via subscription  
Anesthesiology Clinics     Full-text available via subscription   (Followers: 21, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 141, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

        1 2 3 4 5 6 7 8 | Last   [Sort by number of followers]   [Restore default list]

Journal Cover American Journal of Medicine
  [SJR: 2.023]   [H-I: 189]   [48 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0002-9343 - ISSN (Online) 1555-7162
   Published by Elsevier Homepage  [3031 journals]
  • Subscription Information
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5


      PubDate: 2017-04-18T23:21:39Z
       
  • Statins and Diabetes: Wider Utilization Is Needed in Treatment and
           Prevention
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Joseph S. Alpert


      PubDate: 2017-04-18T23:21:39Z
       
  • Free-Floating Right Heart Thrombi
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): James E. Dalen


      PubDate: 2017-04-18T23:21:39Z
       
  • Looking for Sarcopenia Biomarkers
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Yeong-Hau H. Lien


      PubDate: 2017-04-18T23:21:39Z
       
  • Statins and Diabetes: Current Perspectives and Implications for Clinicians
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Charles H. Hennekens, Bettina Teng, Marc A. Pfeffer


      PubDate: 2017-04-18T23:21:39Z
       
  • The Annual Physical: Delivering Value
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): David M. Shein, Valerie E. Stone


      PubDate: 2017-04-18T23:21:39Z
       
  • The New Trend in Medicine
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Bahar Bastani


      PubDate: 2017-04-18T23:21:39Z
       
  • Heart Failure with Preserved Ejection Fraction: Diagnosis and Management
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Ohad Oren, Sheldon Goldberg
      Heart failure with preserved ejection fraction (HFpEF) is a prevalent condition with substantial individual and societal burden. In this article, we review the current status of understanding of HFpEF, focusing on the challenges and uncertainties regarding diagnosis and treatment. We then propose a scientific roadmap to facilitate research that may translate into improved clinical outcomes.

      PubDate: 2017-04-18T23:21:39Z
       
  • Oral Anticoagulant Use After Bariatric Surgery: A Literature Review and
           Clinical Guidance
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Karlyn A. Martin, Craig R. Lee, Timothy M. Farrell, Stephan Moll
      Bariatric surgery may alter the absorption, distribution, metabolism, or elimination (disposition) of orally administered drugs via changes to the gastrointestinal tract anatomy, body weight, and adipose tissue composition. As some patients who have undergone bariatric surgery will need therapeutic anticoagulation for various indications, appropriate knowledge is needed regarding anticoagulant drug disposition and resulting efficacy and safety in this population. We review general considerations about oral drug disposition in patients after bariatric surgery, as well as existing literature on oral anticoagulation after bariatric surgery. Overall, available evidence on therapeutic anticoagulation is very limited, and individual drug studies are necessary to learn how to safely and effectively use the direct oral anticoagulants. Given the sparsity of currently available data, it appears most prudent to use warfarin with international normalized ratio monitoring, and not direct oral anticoagulants, when full-dose anticoagulation is needed after bariatric surgery.

      PubDate: 2017-04-18T23:21:39Z
       
  • The Role of Acid Suppression in Barrett's Esophagus
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Pooja S. Elias, Don O. Castell
      In recent years, proton pump inhibitors (PPIs) have come under great scrutiny due to possible adverse, long-term side effects. At the same time, Barrett's esophagus, a premalignant condition in the esophagus, continues to be a disease whose course is thought to be improved by the use of PPIs. We review the impact of proton pump therapy on the esophagus and on Barrett's mucosa. In analyzing changes on a cellular level, we explore the effect of mixed gastric refluxate and the complex cascade that ensues with esophageal exposure of these contents. Because the incidence of esophageal adenocarcinoma is on the rise, we explore other factors that may contribute to the progression of Barrett's from non-dysplastic mucosa to esophageal adenocarcinoma. By revisiting the need for adequate acid suppression in Barrett's and increasing our understanding of other possible factors that may have an effect of Barrett's progression, we hope to support our multifaceted approach to acid suppression in patients with Barrett's esophagus.

      PubDate: 2017-04-18T23:21:39Z
       
  • Trouble on Both Sides: Pulmonary Embolism with Pneumothorax
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Carlos E. Velasco, Charles Howard


      PubDate: 2017-04-18T23:21:39Z
       
  • So Many Possibilities: Lung Nodules in a Transplant Recipient
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Maroun Sfeir, Elijah Douglass, Rosemary Soave


      PubDate: 2017-04-18T23:21:39Z
       
  • It Looks Familial: Hereditary Hemorrhagic Telangiectasia
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Binod K. Khaitan, Vishal Gupta, Mamta Rai, Ajay Garg


      PubDate: 2017-04-18T23:21:39Z
       
  • A Bumpy Course: Nodules Along a Mastectomy Scar
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Laura Karas, Ramya Vangipuram, Sana Zahiruddin, Kevin G. Sharghi, Andrew Jarad Peranteau, Stephen K. Tyring


      PubDate: 2017-04-18T23:21:39Z
       
  • A Rhythm Revealed: Transient Brugada Pattern
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Julie Shelton, Bennet George, Christian Deutsch, Alison Bailey


      PubDate: 2017-04-18T23:21:39Z
       
  • Prognostic Importance of Low Admission Serum Creatinine Concentration for
           Mortality in Hospitalized Patients
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Charat Thongprayoon, Wisit Cheungpasitporn, Wonngarm Kittanamongkolchai, Andrew M. Harrison, Kianoush Kashani
      Objective The study objective was to assess the association between low serum creatinine value at admission and in-hospital mortality in hospitalized patients. Methods This was a retrospective single-center cohort study conducted at a tertiary referral hospital. All hospitalized adult patients between 2011 and 2013 who had an admission creatinine value available were identified for inclusion in this study. Admission creatinine value was categorized into 7 groups: ≤0.4, 0.5 to 0.6, 0.7 to 0.8, 0.9 to 1.0, 1.1 to 1.2, 1.3 to 1.4, and ≥1.5 mg/dL. The primary outcome was in-hospital mortality. Logistic regression analysis was performed to obtain the odds ratio of in-hospital mortality for the various admission creatinine levels, using a creatinine value of 0.7 to 0.8 mg/dL as the reference group in the analysis of all patients and female patients and of 0.9 to 1.0 mg/dL in the analysis of male patients because it was associated with the lowest in-hospital mortality. Results Of 73,994 included patients, 973 (1.3%) died in the hospital. The association between different categories of admission creatinine value and in-hospital mortality assumed a U-shaped distribution, with both low and high creatinine values associated with higher in-hospital mortality. After adjustment for age, sex, ethnicity, principal diagnosis, and comorbid conditions, very low creatinine value (≤0.4 mg/dL) was significantly associated with increased mortality (odds ratio, 3.29; 95% confidence interval, 2.08-5.00), exceeding the risk related to a markedly increased creatinine value of ≥1.5 mg/dL (odds ratio, 2.56; 95% confidence interval, 2.07-3.17). The association remained significant in the subgroup analysis of male and female patients. Conclusions Low creatinine value at admission is independently associated with increased in-hospital mortality in hospitalized patients.

      PubDate: 2017-04-18T23:21:39Z
       
  • Changes in One-Year Mortality in Elderly Patients Admitted with Acute
           Myocardial Infarction in Relation with Early Management
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Etienne Puymirat, Nadia Aissaoui, Guillaume Cayla, Alexandre Lafont, Elisabeth Riant, Marco Mennuni, Olivier Saint-Jean, Didier Blanchard, Patrick Jourdain, Meyer Elbaz, Patrick Henry, Vincent Bataille, Elodie Drouet, Geneviève Mulak, François Schiele, Jean Ferrières, Tabassome Simon, Nicolas Danchin
      Background Elderly patients are underrepresented in acute myocardial infarction trials. Our aim was to determine whether, in elderly patients, changes in management in the past 15 years are associated with improved 1-year mortality after hospital admission for myocardial infarction. Methods We used data from 4 1-month French registries, conducted 5 years apart from 1995 to 2010, including 3389 elderly patients (≥75 years of age). Results From 1995 to 2010, mean age remained stable (82.1 years), similar in ST- and non-ST-elevation myocardial infarction patients. Obesity, diabetes, hypertension, and hypercholesterolemia increased. History of prior myocardial infarction, stroke, and peripheral artery disease remained stable, while history of heart failure decreased. Major changes in management were noted: early percutaneous coronary intervention, early treatment with antiplatelet agents, low-molecular-weight heparin, beta-blockers, angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and statins all increased. Early mortality after hospital admission decreased from 25.0% to 8.4%. One-year mortality decreased from 36.2% to 20.0% (adjusted hazard ratio 2010 vs 1995: 0.47, 0.39-0.57), both for ST-elevation myocardial infarction (36.8% to 21.1%) and non-ST-elevation myocardial infarction (34.8% to 19.1%). Mortality reduction was observed in all age groups, including those ≥85 years of age (from 46.2% to 31.4%). The study period, however, was no longer associated with decreased mortality when variables reflecting management changes were taken into account. Conclusions Early and 1-year mortality after hospital admission of elderly patients with acute myocardial infarction has substantially decreased over the past 15 years. This improvement is likely mediated by increasing use of recommended management strategies. These data support the application of guidelines derived from trials mostly including younger patients to elderly populations as well.

      PubDate: 2017-04-18T23:21:39Z
       
  • Habitual and Recent Sleep Durations: Graded and Interactive Risk for
           Impaired Glycemic Control in a Biracial Population
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Donald L. Bliwise, Sophia A. Greer, Michael K. Scullin, Lawrence S. Phillips
      Background We examined how habitual sleep duration interacts with recent sleep (2 nights) to predict morning oral glucose tolerance test results. We hypothesized that short habitual and recent sleep durations would be additive for poor glucose control. Methods A biracial population of adults (n = 1559) without known diabetes and recruited from the workforce of 2 urban universities was assessed for glycated hemoglobin and underwent oral glucose tolerance testing. We used plasma 2-hour postloading (75 g) measurements. Participants answered sleep questions using 30-minute forced-choice formats. We employed multivariable logistic regression to derive odds ratios. Results Shorter habitual sleep duration was associated with greater odds ratios of glycated hemoglobin ≥6.0% increasing by 30-minute intervals beginning at <7.0 hours and were more pronounced as durations shortened. Among participants with glycated hemoglobin <6.0% and <7.0 hours of habitual sleep (n = 636), abnormal glucose tolerance (2-hour oral glucose tolerance test ≥140 mg/dL) was significantly associated with a total sleep duration of ≤11 hours the 2 nights preceding oral glucose tolerance testing, but was not associated with longer sleep durations. Results were independent of age, sex, race, body mass index, smoking, history of cardiovascular disease, or use of antihypertensive or cholesterol-lowering medication. Additional analyses implied that longer-than-usual recent sleep durations were protective for abnormal oral glucose tolerance testing. Discussion Short habitual and recent sleep durations interact in predicting abnormal glucose on oral glucose tolerance testing. Self-reported data are sufficiently sensitive to reflect 30-minute differences in sleep between individuals. Future studies examining other aspects of sleep, such as perceived sleep quality and objectively measured sleep duration and architecture, would be necessary to confirm these findings. Conclusions Short sleep duration for 2 nights prior to morning oral glucose tolerance testing may elevate glucose levels, this effect being detected among individuals habitually obtaining <7 hours sleep and obtaining ≤11 hours of sleep for 2 nights preceding testing.

      PubDate: 2017-04-18T23:21:39Z
       
  • Prognostic Value of High-Sensitivity Cardiac Troponin T Compared with Risk
           Scores in Stable Cardiovascular Disease
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Moritz Biener, Evangelos Giannitsis, Manuel Kuhner, Thomas Zelniker, Matthias Mueller-Hennessen, Mehrshad Vafaie, Dietmar Trenk, Franz-Josef Neumann, Willibald Hochholzer, Hugo A. Katus
      Background Risk stratification of patients with cardiovascular disease remains challenging despite consideration of risk scores. Methods We aimed to evaluate the prognostic performance of high-sensitivity cardiac troponin T in a low-risk outpatient population presenting for nonsecondary and secondary prevention. All-cause mortality, a composite of all-cause mortality, acute myocardial infarction, and stroke (end point 2), and a composite of all-cause mortality, acute myocardial infarction, stroke and rehospitalization for acute coronary syndrome, and decompensated heart failure (end point 3) were defined. The prognostic performance of high-sensitivity cardiac troponin T on index visit was compared with the PROCAM score and 3 FRAMINGHAM subscores. Results In 693 patients with a median follow-up of 796 days, we observed 16 deaths, 32 patients with end point 2, and 83 patients with end point 3. All risk scores performed better in the prediction of all-cause mortality in nonsecondary prevention (area under the curve [AUC]: PROCAM: 0.922 vs 0.523, P = .001, consistent for all other scores). In secondary prevention, high-sensitivity cardiac troponin T outperformed all risk scores in the prediction of all-cause mortality (ΔAUC: PROCAM: 0.319, P <.001, consistent for all other scores) and performed superiorly in the prediction of end point 2 compared with the PROCAM, FRAMINGHAM-Coronary Heart Disease, and FRAMINGHAM-Hard Coronary Heart Disease scores (ΔAUC: PROCAM: 0.176, P = .047, consistent for FRAMINGHAM-Coronary Heart Disease and FRAMINGHAM-Hard Coronary Heart Disease). In nonsecondary prevention, we observed a comparable prognostic performance of high-sensitivity cardiac troponin T and multivariable risk scores. Our findings on the prediction of all-cause mortality compared with the FRAMINGHAM-Hard Coronary Heart Disease score were confirmed in an independent validation cohort on 2046 patients. Conclusions High-sensitivity troponin T provides excellent risk stratification regarding all-cause mortality and all-cause mortality, acute myocardial infarction, and stroke in a secondary prevention cohort in whom risk scores perform poorly.

      PubDate: 2017-04-18T23:21:39Z
       
  • Risk of Colchicine-Associated Myopathy in Gout: Influence of Concomitant
           Use of Statin
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Oh Chan Kwon, Seokchan Hong, Byeongzu Ghang, Yong-Gil Kim, Chang-Keun Lee, Bin Yoo
      Objective The purpose of this study was to investigate the risk of myopathy when statins are coadministered with colchicine in patients with gout. Methods In gout patients who received colchicine with or without statin, clinical data collected included medications and history of hypertension, chronic kidney disease, and liver cirrhosis. Myopathy was defined as the presence of muscle symptoms with elevated creatine kinase or myoglobin. Multivariate analysis was performed to identify risk factors for myopathy. Inverse probability of treatment weighting (IPTW)-adjusted analysis was used to evaluate the influence of concomitant colchicine and statin use on myopathy. Results Of 674 patients, 486 received colchicine alone and 188 also received statin. The incidence of myopathy was not significantly higher in those on both drugs than in those on colchicine alone (2.7% vs 1.4%, P = .330). On multivariate analysis, chronic kidney disease (hazard ratio [HR] 29.056; 95% confidence interval [CI], 4.387-192.450; P <.001), liver cirrhosis (HR 10.676; 95% CI, 1.279-89.126; P = .029), higher colchicine dose (HR 20.960; 95% CI, 1.835-239.481; P = .014), and concomitant CYP3A4 inhibitor (HR 12.027; 95% CI, 2.743-52.725; P = .001) were associated with increased risk of myopathy. Concomitant use of statins, however, was not, even after adjusting for confounders (HR 1.123; 95% CI, 0.262-4.814; P = .875; IPTW-adjusted HR 0.321; 95% CI, 0.077-1.345; P = .120). Conclusion Concomitant use of statin and colchicine was not associated with increased risk of myopathy. Thus, concomitant use of statin with colchicine seems to be safe from myotoxicity in gout patients.

      PubDate: 2017-04-18T23:21:39Z
       
  • Treatment of Right Heart Thrombi Associated with Acute Pulmonary Embolism
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Deisy Barrios, Jeremy Chavant, David Jiménez, Laurent Bertoletti, Vladimir Rosa-Salazar, Alfonso Muriel, Alain Viallon, Carmen Fernández-Capitán, Roger D. Yusen, Manuel Monreal
      Background Evidence-based recommendations do not adequately address the treatment of right heart thrombi in patients who present with acute symptomatic pulmonary embolism. Methods This study included patients who had acute pulmonary embolism associated with right heart thrombi and participated in the Registro Informatizado de la Enfermedad TromboEmbólica registry. We assessed the effectiveness of anticoagulation versus reperfusion treatment for the outcomes of all-cause mortality, pulmonary embolism–related mortality, recurrent venous thromboembolism, and major bleeding rates through 30 days after initiation of pulmonary embolism treatment. We used propensity score matching to adjust for the likelihood of receiving reperfusion treatment. Results Of 325 patients with pulmonary embolism and right heart thrombi, 255 (78%; 95% confidence interval, 74-83) received anticoagulation and 70 (22%; 95% confidence interval, 17-26) also received reperfusion treatment. Propensity score–matched pairs analyses did not detect a statistically lower risk of all-cause death (6.2% vs 14%, P = .15) or pulmonary embolism–related mortality (4.7% vs 7.8%; P = .47) for reperfusion compared with anticoagulation. Of the patients who received reperfusion treatment, 6.2% had a recurrence during the study follow-up period, compared with 0% of those who received anticoagulation (P = .049). The incidence of major bleeding events was not statistically different between the 2 treatment groups (3.1% vs 3.1%; P = 1.00). Conclusions In patients with pulmonary embolism and right heart thrombi, no significant difference was found between reperfusion therapy and anticoagulant therapy for mortality and bleeding. The risk of recurrences was significantly higher for reperfusion therapy compared with anticoagulation. Right heart thrombi may not warrant riskier interventions than standard anticoagulation.

      PubDate: 2017-04-18T23:21:39Z
       
  • In-Hospital Mortality with Deep Venous Thrombosis
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Paul D. Stein, Fadi Matta, Mary J. Hughes
      Background Little is known about the in-hospital mortality of deep venous thrombosis in recent years. This investigation was undertaken to determine trends in in-hospital mortality in patients with deep venous thrombosis and mortality according to age. Methods Administrative data were analyzed from the National (Nationwide) Inpatient Sample, 2003-2012. We determined in-hospital all-cause mortality according to year and age among patients with a primary (first-listed) diagnosis of deep venous thrombosis. We analyzed all such patients and we analyzed those who had none of the comorbid conditions listed in the Charlson Comorbidity Index. Results From 2003-2012, 1,603,690 hospitalized patients had a primary diagnosis of deep venous thrombosis. All-cause in-hospital mortality decreased from 1.3% in 2003 to 0.6% in 2012. Mortality increased with age from 0.1% in those aged 18-20 years to 1.5% in those over age 80 years. All-cause in-hospital mortality in those with no comorbid conditions according to the Charlson Comorbidity Index (1,094,184 patients) decreased from 1.1% in 2003 to 0.5% in 2012. Presumably, these deaths were from pulmonary embolism. All-cause mortality in those with no comorbid conditions increased with age from 0.1% in those aged 18-20 years to 1.4% in those over aged 80 years. Conclusion All-cause death and death due to pulmonary embolism in patients hospitalized with a primary diagnosis of deep venous thrombosis decreased from 2003-2012. The death rate increased with age. The decreased mortality over the period of investigation may have resulted from a shift toward use of low-molecular-weight heparins and newer anticoagulants.

      PubDate: 2017-04-18T23:21:39Z
       
  • What's in a Mass?: Large Native Mitral Valve Mass
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Stacey J. Howell, Ananya Datta Mitra, Ezra A. Amsterdam


      PubDate: 2017-04-18T23:21:39Z
       
  • Curious Case of Wheezing: Carcinoid Heart Disease
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Dhaval Desai, M. Fuad Jan, Nataly Stenzel, Paul Werner, A. Jamil Tajik


      PubDate: 2017-04-18T23:21:39Z
       
  • Gastric Crohn's Disease: A Rare Cause of Intermittent Abdominal Pain and
           Vomiting
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Xu-Ting Zhi, Jian-Guo Hong, Tao Li, Dong Sun, De-Xin Yu, Zhi-Qiang Chen, Tao Li


      PubDate: 2017-04-18T23:21:39Z
       
  • Cerebral Fat Embolism in Hemoglobin SC Disease
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Carole Scheifer, François Lionnet, Claude Bachmeyer, Katia Stankovic-Stojanovic, Sophie Georgin-Lavialle, Sonia Alamowitch, Beatrice Marro, Sarah Mattioni


      PubDate: 2017-04-18T23:21:39Z
       
  • Derivation and Internal Validation of a Clinical Prediction Tool for
           30-Day Mortality in Lower Gastrointestinal Bleeding
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Neil Sengupta, Elliot B. Tapper
      Background There are limited data to predict which patients with lower gastrointestinal bleeding are at risk for adverse outcomes. We aimed to develop a clinical tool based on admission variables to predict 30-day mortality in lower gastrointestinal bleeding. Methods We used a validated machine learning algorithm to identify adult patients hospitalized with lower gastrointestinal bleeding at an academic medical center between 2008 and 2015. The cohort was split randomly into derivation and validation cohorts. In the derivation cohort, we used multiple logistic regression on all candidate admission variables to create a prediction model for 30-day mortality, using area under the receiving operator characteristic curve and misclassification rate to estimate prediction accuracy. Regression coefficients were used to derive an integer score, and mortality risk associated with point totals was assessed. Results In the derivation cohort (n = 4044), 8 variables were most associated with 30-day mortality: age, dementia, metastatic cancer, chronic kidney disease, chronic pulmonary disease, anticoagulant use, admission hematocrit, and albumin. The model yielded a misclassification rate of 0.06 and area under the curve of 0.81. The integer score ranged from −10 to 26 in the derivation cohort, with a misclassification rate of 0.11 and area under the curve of 0.74. In the validation cohort (n = 2060), the score had an area under the curve of 0.72 with a misclassification rate of 0.12. After dividing the score into 4 quartiles of risk, 30-day mortality in the derivation and validation sets was 3.6% and 4.4% in quartile 1, 4.9% and 7.3% in quartile 2, 9.9% and 9.1% in quartile 3, and 24% and 26% in quartile 4, respectively. Conclusions A clinical tool can be used to predict 30-day mortality in patients hospitalized with lower gastrointestinal bleeding.

      PubDate: 2017-04-18T23:21:39Z
       
  • Risk Factors for 30-Day Readmission in Adults with Sickle Cell Disease
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Max A. Brodsky, Mark Rodeghier, Maureen Sanger, Jeannie Byrd, Brandi McClain, Brittany Covert, Dionna O. Roberts, Karina Wilkerson, Michael R. DeBaun, Adetola A. Kassim
      Background Readmission to the hospital within 30 days is a measure of quality care; however, only few modifiable risk factors for 30-day readmission in adults with sickle cell disease are known. Methods We performed a retrospective review of the medical records of adults with sickle cell disease at a tertiary care center, to identify potentially modifiable risk factors for 30-day readmission due to vasoocclusive pain episodes. A total of 88 patients ≥18 years of age were followed for 3.5 years between 2010 and 2013, for 158 first admissions for vasoocclusive pain episodes. Of these, those subsequently readmitted (cases) or not readmitted (controls) within 30 days of their index admissions were identified. Seven risk factors were included in a multivariable model to predict readmission: age, sex, hemoglobin phenotype, median oxygen saturation level, listing of primary care provider, type of health insurance, and number of hospitalized vasoocclusive pain episodes in the prior year. Results Mean age at admission was 31.7 (18-59) years; median time to readmission was 11 days (interquartile range 20 days). Absence of a primary care provider listed in the electronic medical record (odds ratio 0.38; 95% confidence interval, 0.16-0.91; P = .030) and the number of vasoocclusive pain episodes requiring hospitalization in the prior year were significant risk factors for 30-day readmission (odds ratio 1.30; 95% confidence interval, 1.16-1.44; P <.001). Conclusion Improved discharge planning and ensuring access to a primary care provider may decrease the 30-day readmission rate in adults with sickle cell disease.

      PubDate: 2017-04-18T23:21:39Z
       
  • Using the Electronic Medical Record to Identify Patients at High Risk for
           Frequent Emergency Department Visits and High System Costs
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): David W. Frost, Shankar Vembu, Jiayi Wang, Karen Tu, Quaid Morris, Howard B. Abrams
      Background A small proportion of patients account for a high proportion of healthcare use. Accurate preemptive identification may facilitate tailored intervention. We sought to determine whether machine learning techniques using text from a family practice electronic medical record can be used to predict future high emergency department use and total costs by patients who are not yet high emergency department users or high cost to the healthcare system. Methods Text from fields of the cumulative patient profile within an electronic medical record of 43,111 patients was indexed. Separate training and validation cohorts were created. After processing, 11,905 words were used to fit a logistic regression model. The primary outcomes of interest in the 12 months after prediction were 3 or more emergency department visits and being in the top 5% in healthcare expenditures. Outcomes were assessed through linkage to administrative databases housed at the Institute for Clinical Evaluative Sciences. Results In the model to predict frequent emergency department visits, after excluding patients who were high emergency department users in the previous year, the area under the receiver operating characteristic curve was 0.71. By using the same methodology, the model to predict the top 5% in total system costs had an area under the receiver operating characteristic curve of 0.76. Conclusions Machine learning techniques can be applied to analyze free text contained in electronic medical records. This dataset is more predictive of patients who will generate future high costs than future emergency department visits. It remains to be seen whether these predictions can be used to reduce costs by early interventions in this cohort of patients.

      PubDate: 2017-04-18T23:21:39Z
       
  • Primary Care Management of Skin Abscesses Guided by Ultrasound
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Laura J.S. Greenlund, Stephen P. Merry, Tom D. Thacher, William J. Ward
      Background Primary care providers often manage skin abscesses in the outpatient setting. Estimating the size and depth of an abscess, and distinguishing abscess from cellulitis by clinical examination can be challenging due to surrounding firm tissue induration. Definitive treatment of abscess requires incision and drainage, and the approach chosen may be altered by abscess size, depth, and surrounding neurovascular structures. Methods For 31 consecutive patients seen in the primary care outpatient clinic, we prospectively compared the estimated size of skin abscesses by clinical examination with that determined by ultrasound. Prior to incision and drainage, a limited point-of-care ultrasound examination was performed and the abscess dimensions were measured, the depth was determined, and adjacent vascular structures were noted. Based on ultrasound findings, physicians reported whether the decision to perform the procedure or the techniques used to perform the procedure were altered by the scan. Results The clinical examination was inaccurate for size estimation by >0.5 cm in 16 of 31 patients (52%). Ultrasound examination changed the physician decision of whether or not incision and drainage should be performed in 7 patients (23%) and altered the technique/approach in an additional 10 patients (32%); thus, management was changed in 55% of cases. Physician confidence in performing the procedure was improved in 16 cases (52%). Conclusion Outpatient procedural management of skin abscesses by primary care physicians was altered in more than half the cases by performing point-of-care ultrasound prior to incision and drainage.

      PubDate: 2017-04-18T23:21:39Z
       
  • Idarucizumab (Praxbind): The First Reversal Agent for a Direct Oral
           Anticoagulant
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Shannon W. Finks, Kelly C. Rogers


      PubDate: 2017-04-18T23:21:39Z
       
  • An Explosive Idea for the Nobel Prize in Medicine!
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Gary P. Wormser


      PubDate: 2017-04-18T23:21:39Z
       
  • Bacteriuria/Pyuria of Clinically Undetermined Significance (BPCUS):
           Common, but Currently Nameless
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): James R. Johnson, Dimitri M. Drekonja


      PubDate: 2017-04-18T23:21:39Z
       
  • Tele-Ultrasound to Guide Management of a Patient with Circulatory Shock
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Christian Becker, Mario Fusaro, Dhruv Patel, Isaac Shalom, William H. Frishman, Corey Scurlock


      PubDate: 2017-04-18T23:21:39Z
       
  • Immunotherapy in Squamous Cell Skin Carcinoma: A Game Changer?
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Sravanthi Ravulapati, Cerena Leung, Nishant Poddar, Yifan Tu


      PubDate: 2017-04-18T23:21:39Z
       
  • Venturing Out on a Limb: Axillary Web Syndrome
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Heather A. Thompson Buum, Linda Koehler, Todd M. Tuttle


      PubDate: 2017-04-18T23:21:39Z
       
  • Diffuse Cerebral Edema from Acute Pancreatitis Induced by
           Hypertriglyceridemia
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Dalvir Gill, Natasha Sheikh, Amish Shah, Vanessa Goyes Ruiz, Dana Savici


      PubDate: 2017-04-18T23:21:39Z
       
  • Effusive Constrictive Pericarditis in Autoimmune Polyglandular Syndrome
           Type II
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): David McNamara, Haru Yamamoto, Venetia Sarode, Vlad G. Zaha


      PubDate: 2017-04-18T23:21:39Z
       
  • The Eyes Are Useless When the Mind Is Blind: A Rare Case of
           Anton-Babinski Syndrome in Hepatic Encephalopathy
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Sanlly Perez-Ceballos, Francisco T. Fernandez-Rodriguez, Neel Shah, Priyanka Wani-Parekh, Lyan Gondin-Hernandez, Jose L. Gonzalez-Martinez, Mateo Porres-Muñoz, Mateo Porres-Aguilar


      PubDate: 2017-04-18T23:21:39Z
       
  • Wunderlich Syndrome
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Aron Simkins, Abhishek Maiti, Sujith V. Cherian


      PubDate: 2017-04-18T23:21:39Z
       
  • Errancy on Lyme Diagnosis
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Christian Perronne, Alexis Lacout, Pierre-Yves Marcy, Mostafa El Hajjam


      PubDate: 2017-04-18T23:21:39Z
       
  • Dealing with Lyme Disease Treatment
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Alexis Lacout, Pierre Yves Marcy, Mostafa El Hajjam, Juliette Thariat, Christian Perronne


      PubDate: 2017-04-18T23:21:39Z
       
  • The Reply
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Jerome Goddard


      PubDate: 2017-04-18T23:21:39Z
       
  • Electronic Stethoscope for Coronary Stenosis Detection
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Robert L. Rosenthal


      PubDate: 2017-04-18T23:21:39Z
       
  • The Reply
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Robert F. Wilson, Farzad Azimpour


      PubDate: 2017-04-18T23:21:39Z
       
  • Intravenous Formulation Considerations for Hyponatremia
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Prakash Bhagudas, Todd Canada


      PubDate: 2017-04-18T23:21:39Z
       
  • The Reply
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Demetra Tsapepas, Maya K. Rao, Mariana C. Chiles, Sumit Mohan


      PubDate: 2017-04-18T23:21:39Z
       
  • Intermediate–High-Risk Pulmonary Embolism: Standardizing Definition and
           Optimizing Therapeutic Strategies
    • Abstract: Publication date: May 2017
      Source:The American Journal of Medicine, Volume 130, Issue 5
      Author(s): Mateo Porres-Muñoz, Mateo Porres-Aguilar


      PubDate: 2017-04-18T23:21:39Z
       
 
 
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